Journals / Medical Network Klinik Bilimler ve Doktor / 2000 / Cilt: 6 - Sayı: 3
Fournier's gangrene
- Pages
- 326–329
- DOI
- —
Abstract
AIM: We examined 9 patients files, who were treated in our clinic between the years of 1986 and 1997, retrospectively in order to present our management and results in therapy of Fournier's gangrene. MATERIAL AND METHOD: Data were collected on medical history, signs and symptoms, hospitalisation time, bacteriology and management during hospitalisation. All cases were male and there were co-morbid factors in seven, etiologic factors were present in six of them. Management has begun with urgent surgical therapy after aggressive hemodynamic stabilization followed by parenteral antibiotics. Debridement of certain areas in operation was followed by debridement 3 times in a day by making new incisions if necessary. Reconstruction of defective areas were performed by Plastic and Reconstructive Surgery Department after meanly 24 days of therapy. RESULTS: One patient died in the fifth day of hospitalisation because of cardiopulmonary insufficiency. It was observed that, hospitalisation time is longer than the others in the old patients with co-morbid factors. Mortality rate for nine cases for whom radical debridement and hyperbaric oxygen therapy were not used, is %12. CONCLUSION: There will be better results in treatment of Fournier's Gangrene by parenteral antibiotics,-aggressive hemodynamic stabilization and avoiding from radical debridement which may be a debilitating factor for old patients.
Özet
AMAÇ: Yaklaşım ve sonuçlarımızı sunmak amacıyla 1986-1997 Yılları arasında Fournier gangreni tanısıyla takip edilen hastalara ait veriler retrospektif olarak incelendi. GEREÇ V.E YÖNTEM: Tüm hastalar geniş spektrumlu parenteral antibiyotik tedavisi altında acil operasyona alınarak tamamen nekrotik olan sahalar- eksize edilmiş ve şüpheli alanlara insizyonlar açılarak günde 3 kez debridmanh pansuman ile takip edilmiştir: BULGULAR: Hastalar ilk yakınmalarının ortaya çıkışından ortalama 7 gün sonra (2-21) hastaneye başvurmuşlardır. 6 hastada (%66) etiyolojik faktör bulunurken, 3 hastada herhangi bir faktör bulunamamıştır. Sekiz hastanın cilt açıklıkları ortalama 24 günlük (18-45) tedaviyi takiben Plastik ve Rekonstrüktif Cerrahi Bölümü tarafından kapatılmıştır. Bir hasta ise alemin beşinci gününde kardiyakyetmezlik nedeniyle kaybedilmiştir. SONUÇ: Fournier gangreninin tedavisinde genel vücut direncini daha kötüye götürecek radikal cerrahi yaklaşımdan : kaçınılmasının, uygun antibiyotik ve destekleyici tedavinin tatminkar sonuç yaratacağı düşüncesindeyiz.